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Human Reproduction, Vol. 18, No. 1, 192-198, January 2003
© 2003 European Society of Human Reproduction and Embryology

Raloxifene administration in post-menopausal women with osteoporosis: effect of different BsmI vitamin D receptor genotypes

Stefano Palomba1,4, Fabio Giuliano Numis2, Giuseppe Mossetti2, Domenico Rendina2, Pietro Vuotto2, Tiziana Russo1, Fulvio Zullo1, Carmine Nappi3 and Vincenzo Nunziata2

1 Department of Obstetrics & Gynaecology, University of Catanzaro, Catanzaro, 2 Department of Clinical and Experimental Medicine and 3 Department of Gynaecology, Obstetrics and Human Reproduction, University of Naples ‘Federico II’, Naples, Italy 4 To whom correspondence should be addressed at: Via Nicolardi 188, Napoli 80131, Italy. e-mail: stefanopalomba{at}tin.it

BACKGROUND: The vitamin D receptor (VDR) gene polymorphism has been considered a factor influencing the effectiveness of the anti-osteoporotic treatments. The aim of this study was to correlate the effectiveness of raloxifene treatment in post-menopausal women with osteoporosis to BsmI VDR genotypes. METHODS: Between January and August 2000, 75 Italian osteoporotic women were enrolled and treated with raloxifene at a dose of 60 mg/day. At entry and after 1 year of treatment, lumbar bone mineral density (BMD), serum osteocalcin (OC) and urinary creatinine-corrected free deoxypyridinoline (DPD) levels were evaluated. DNA was extracted from blood and analysed with restriction endonuclease BsmI for VDR gene. RESULTS: After treatment, a significant increase in lumbar BMD and a significant reduction in serum OC and urinary DPD levels were observed. The percentage of change (mean ± SD) in lumbar BMD, and in serum OC and urinary DPD levels was significantly different in homozygous bb (1.58 ± 0.80, –5.15 ± 2.36 and –7.71 ± 2.89 for BMD, OC and DPD respectively) in comparison with BB (4.13 ± 2.26, –13.59 ± 4.68 and –15.16 ± 4.65 for BMD, OC and DPD respectively) BsmI VDR genotypes. Heterozygous Bb VDR patients showed an intermediate percentage (mean ± SD) of BMD, serum OC and urinary DPD change (2.49 ± 1.54, –8.69 ± 2.60 and –10.52 ± 2.56 for BMD, OC and DPD respectively) not significantly different in comparison with homozygous BB and bb. CONCLUSIONS: In post-menopausal women with osteoporosis the effectiveness of raloxifene treatment on bone metabolism seems to be controlled by different BsmI VDR genotypes.

Key words: bone mineral density/osteoporosis/post-menopause/raloxifene/vitamin D receptor gene polymorphisms


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